If you or your loved one is a National Disability Insurance Scheme (NDIS) participant, you may sometimes feel that your plan no longer meets your needs. Maybe your funding request was rejected, or your situation has changed. When this happens, you have the right to request a NDIS review.
The good news: you have several options to address this. The NDIS offers different types of reviews and knowing which one to choose can make a big difference.
Why ask for a review?
Life is unpredictable. A person’s disability may progress, a carer may become unwell, or new supports may be needed. If your plan no longer works for you, a review can help you get the right support.
How to request a review when your situation has changed?
Unscheduled review:
If your circumstances change significantly, such as a new diagnosis, worsening health, or loss of informal supports, you can request an unscheduled review at any time. This is often called a Change in Circumstances review and requires strong evidence to explain the changes.
Complete the ‘Change of details or change of situation’ form and include comprehensive evidence to support your request.
Plan variation:
Sometimes only minor adjustments are needed, such as changing your plan management type. The NDIS may allow a plan variation without a full reassessment. This is usually faster and can be completed in about 28 days.
What if your request is declined or if NDIS makes a decision that doesn’t meet your needs?
Internal review of a decision (Section 100 Review)
If the NDIS declines a request, such as additional funding or new supports, you can apply for an internal review within three months of the decision.
A different NDIS staff member will review your case, and you can submit new evidence such as medical reports or family statements.
External review by the Administrative Review Tribunal (ART)
If you’re still unhappy after the internal review, you can escalate to the Administrative Review Tribunal (ART). The ART is an independent tribunal with the authority to overturn NDIS decisions. Applications must be lodged within 28 days of the internal review outcome. Depending on the circumstance, the ART may accept a request for an extension to lodge an external review.
Preparing well for NDIS Reviews
Here’s how to navigate the process effectively and improve your chances of a successful outcome.
1. Understand your review options
When the NDIS rejects a funding request, you can ask for an internal review of the decision. If the internal review does not resolve the issue, you can escalate to an external review through the Administrative Review Tribunal (ART).
If you are unsure about the process, you can reach out to advocacy services. Your Support Coordinator can help you explore advocacy options. Once available, the advocate will take over to assist you directly with this review process.
2. Gather strong evidence
The success of your review often depends on the quality of your supporting evidence. Consider including:
- Updated medical or therapy reports that show the impact of your or your loved one’s disability.
- Documentation explaining why the requested supports are reasonable and necessary under NDIS guidelines.
- Statements from allied health professionals, support coordinators, or family members detailing changes in circumstances.
Evidence doesn’t need to be limited to NDIS supports. Documents from mainstream services, such as hospital discharge summaries or mental health care plans, can strengthen your case.
If your situation has changed significantly, such as a new diagnosis or loss of informal supports, make sure this is clearly documented
3. Your rights during the process
Your rights include:
- A written explanation of the original decision and the review outcome.
- The ability to submit new evidence during the review.
- Support from advocates or support coordinators to help you navigate the process.
How Mosaic Community Care can help
The review process can feel overwhelming, but you don’t have to go through it alone. Mosaic’s Support Coordination (SC) team specialises in helping families prepare strong review submissions.
Real-life examples of Mosaic’s impact:
Primary carer becomes unwellBefore engaging Mosaic’s Support Coordination (SC) services, a family requested additional funding for support work after the client’s mother – also the plan nominee and primary carer – became unwell and was hospitalised. The NDIS initially declined the request. After onboarding with Mosaic’s SC services, our team assisted with the appeal by submitting the S100 form and worked with the family to include a detailed family statement. Outcome: An additional $30,000 was funded, enabling the client to access the assistance he needed. |
Qualifying disability-related support under the NDISA Mosaic client with Emotionally Unstable Personality Disorder (EUPD) wanted to access psychology services under the NDIS; a request often declined as it typically falls under mainstream health. The client’s Change in Circumstances review was rejected, followed by an internal review that was also declined. Our Specialist Support Coordination (SSC) team helped link the client with advocacy services and escalate the request to the ART. The SSC team collaborated with internal and external stakeholders to gather comprehensive evidence showing the need was disability-related. Outcome: During negotiations, the NDIS agreed to provide a once-off 48 hours of psychology support for the year. |
Important note: Outcomes of reviews aren’t guaranteed. Decisions depend on factors such as diagnosis complexity and level of support required, and the final decision rests solely with the NDIS.
These examples show how professional guidance can make a significant difference. Mosaic ensures your submission is clear, evidence-based, and aligned with NDIS requirements.
If you’re facing a funding rejection or need help with a NDIS review, contact us on 08 9314 8900 or book an appointment to meet our Support Coordination team. We’re here to help you secure the support you or your loved one deserves.